Provider Demographics
NPI:1124346127
Name:CERENEHOPE INC,
Entity type:Organization
Organization Name:CERENEHOPE INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BIRDETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDINER-PARKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:646-691-6481
Mailing Address - Street 1:1730 PRESIDENT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-5046
Mailing Address - Country:US
Mailing Address - Phone:646-691-6481
Mailing Address - Fax:718-771-8095
Practice Address - Street 1:1730 PRESIDENT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-5046
Practice Address - Country:US
Practice Address - Phone:646-691-6481
Practice Address - Fax:718-771-8095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0464111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN34S11Medicare PIN
NYQ58559Medicare UPIN